Provider Demographics
NPI:1851436331
Name:SCHWAB-DAVIS, ANN ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:ELIZABETH
Last Name:SCHWAB-DAVIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5945 GOODRICH RD
Mailing Address - Street 2:P.O.BOX 53
Mailing Address - City:CLARENCE CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:14032-9710
Mailing Address - Country:US
Mailing Address - Phone:716-741-2835
Mailing Address - Fax:716-741-8154
Practice Address - Street 1:5945 GOODRICH RD
Practice Address - Street 2:
Practice Address - City:CLARENCE CENTER
Practice Address - State:NY
Practice Address - Zip Code:14032-9710
Practice Address - Country:US
Practice Address - Phone:716-741-2835
Practice Address - Fax:716-741-8154
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04546711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4001415OtherINDEPENDENT HEALTH
NY01501275Medicaid